Clinical Edge

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Chemotherapy Dosing and Ovarian Ca Survival

What role does BMI play?

Body size should not be a major factor influencing dose reduction decisions in women with ovarian cancer, although women who were obese at diagnosis appeared to have better survival in a study of 806 patients receiving adjuvant first-line therapy of carboplatin and paclitaxel with curative intent. Obese Class-III women received 38% and 45% lower doses in milligrams per kilogram of body weight of paclitaxel and carboplatin, respectively. Researchers found:

• Lower average RDI (ARDI) (<70%) was associated with worse overall (HR=1.62) and ovarian cancer-specific survival (HR=1.69).

• Normal-weight women with dose reduction (ARDI<85%) experienced worse survival (HR=1.50).

• For each BMI category, those with ARDI <85% had worse survival than those without dose reduction.

Citation: Bandera EV, Lee VS, Rodriguez L, Powell CB, Kushi LH. Impact of chemotherapy dosing on ovarian cancer survival according to body mass index. JAMA Oncol. 2015;1(6):737-745. doi: 10.1001/jamaoncol.2015.1796.